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Recognising PTSD

Post Traumatic Stress Disorder (PTSD) is a mental health issue that has existed for a very long time.

First diagnosed as a medical condition called Shell Shock during WW1 – when soldiers in the trenches were psychologically broken by the horrors of combat – and  renamed Battle Fatigue during WW2, the condition was examined in more detail following the Vietnam War.

Veterans returning home from combat in SE Asia suffered greatly from feelings of detachment, hostility, numbness and rage. Suicidal thoughts – along with actual deaths – were also common.

But because these mental wounds were with them after  they had returned home (rather than in the field)  and were, in many ways, invisible to the outside world, it took some time for the medical profession to appreciate that these mental injuries could be widespread and long lasting; in the 80s the condition was reclassified with a new, more medical name – PTSD.

The other learning that came about during this time was that PTSD isn’t just something that affects military personnel; nor is it only triggered by direct experiences of combat and warfare. Today it’s recognised as being prevalent in survivors of mass or school shootings, near death experiences (both accidental or due to ill health), victims of sexual assault, people caught up in terrorism and more.

But while the condition is widely known and spoken about, recognising PTSD in yourself can often be challenging; yet it can have adverse effects on a person if left untreated.

PTSD usually manifests itself a few weeks after the event; although for some people it can be months or even years. Delayed PTSD can be a tricky one as people will often put the problem down to something else (i.e. it can’t be that – it was months ago, I’m fine. Maybe it’s XYZ).

The National Health Service in Britain lists the following symptoms of PTSD (although this list is by no means exhaustive)

  • Re-experiencing is the most typical symptom of PTSD. And can manifest itself as
    • flashbacks
    • nightmares
    • repetitive and distressing images or sensations
    • physical sensations, such as pain, sweating, feeling sick or trembling
  • Avoidance and emotional numbing
  • Hyperarousal (feeling ‘on edge’) which can in turn lead to
    • irritability
    • angry outbursts
    • sleeping problems (insomnia)
    • difficulty concentrating

Quite often, symptoms can be accompanied by other feelings or actions. Depression, anxiety and guilt are not uncommon. Drink and drug abuse can often accompany someone suffering from PTSD. Even feelings of physical pain or dizziness can occur.

Sometimes it can be hard to spot some of these feelings in yourself – especially when it comes to mood related issues – as, quite often, the change can be gradual and you may not even be aware of it yourself, but friends and family will and many will flag this to you. Your initial reaction may well be denial, anger, irritation etc; this is to be expected, but try and be mindful that they are doing this with the best of intentions and they may well be right. Take a step back, think about what’s been said and see if there’s truth in what they say.

Understanding and accepting there may be issues is, to coin a cliché, the first step on the road to recovery.

Skills utilised:
Crisis Hub

PTSD Awareness – how to support yourself and others, information and signs

After over two years of a still ongoing global pandemic, the events in Ukraine are a lot to take in, to process and to understand.

Feeling overwhelmed is a perfectly normal response to what we are seeing unfold in Eastern Europe – be that on the ground, or from a far on television and via social media – as is experiencing a range of emotions, not least frustration, sadness, helplessness and anger.

Those prone to depression or who have experienced trauma may find themselves struggling more than they otherwise might in less fraught circumstances, and while something like PTSD can take many different forms, being aware of what to look out for, and, crucially, where to turn for help is important.

PTSD is estimated to affect around one in every three people who have experienced traumatic events, and, while it can develop immediately after the experience, it can also occur weeks, months and sometimes even years later. Again, PTSD can manifest in many different ways, and can present physical, mental and emotional difficulties – with everything from trouble sleeping to unwanted memories, nightmares, flashbacks and panic attacks among the most common challenges.

Cognitive Behavioural Therapy is considered one of the most effective ways to treat PTSD, but there are a number of practical, shorter-term suggestions that can help you and/or those around you when suffering from an episode or flashback.

 

What you can do

 

Breathe

It sounds simple, but focusing on your breathing is a great way of reducing stress and feelings of panic. Try taking a deep breath, counting to five, and exhaling.

Get comfortable

Comfortable surroundings can help us relax. If that’s pouring yourself a hot drink, wrapping up in a duvet blanket, or running yourself a nice hot bath, being able to switch off from the real world and focus on yourself is key.

Allow yourself to be distracted

If possible, a long walk, run or other fitness activity is a great way of clearing the mind. If that’s not your thing, settling in with a good book, movie, television show or video game might work better. Johnny Chiodini’s Low Batteries series (published on Eurogamer back in 2015) takes a wholesome and thoughtful look at video games and mental health, with this episode specifically exploring how PTSD is handled in games.

If you’re simply looking for relaxing games to preoccupy your mind, this best relaxing games list from GamesRadar includes everything from Journey to Dreams, Animal Crossing: New Horizons, Abzu, Stardew Valley and much more.

Stay connected

Stay connected by spending time with the people who give you a sense of security, calmness and happiness, or those who best understand what you are feeling. Whether this is face-to-face or remotely via social media, instant messaging or online video games isn’t important – making connections and maintaining a sense of togetherness is. It’s worth noting that while social media can be a great way to achieve connectedness, if media exposure is impacting your wellbeing, limiting your screen time is equally important.

What friends and family can do

 

Listen

Listening isn’t just about making time for someone, it’s also about allowing them to be upset without judgement or pressure. Simply be there for someone without question.

Identify warning signs and learn triggers 

PTSD is so idiosyncratic, which makes understanding and identifying warning signs and learning triggers especially important – for both the person with PTSD and you. Are there conversations or surroundings that tend to trigger flashbacks? Being able to avoid these can be vital, and if that’s impossible, being able to prepare for them is just as important.

Respect personal space

While being able to listen is crucial, so too is respecting the space of someone who experiences PTSD. Always ask permission if you plan to touch the person, be sure not overcrowd and do what you can to avoid startling them.

Write a crisis plan

Crisis plans can help with all of the above. Mental health charity Mind has some great, easy to follow step-by-step crisis plan advice.

Skills utilised:
Crisis Hub

Small Shoulders & Heavy Burdens: Coming to Terms with my PTSD – By Richard Lee Breslin

I never knew it at the time, but as a child growing up in the 80’s, I was an undiagnosed child with Asperger’s. It never crossed my mind at the time, as I was just a child that loved comics, football and wrestling.  I was also quite an isolated child I enjoyed time to myself, time to immerse myself into what imaginary worlds I could conjure up. But I also wanted to make friends, perhaps I was a little over-bearing in doing so.

I was clearly perceived by the other children as being different and consequently, I was bullied a lot. Not only by name-calling, but physically attacked too. It didn’t matter whether it was on the street of my house or at school, it was everyday, for years.

My mother always used to tell me “not to go round the corner”, but I never always listened. I was often in my own bubble. I became even more isolated and used to wander, sometimes for miles, which would always result in my parents frantically searching the streets for me. I used to think nothing of it at the time, I felt very little about what was right or wrong. But as a parent now, I understand that anxiety for your child.

I couldn’t pinpoint my exact age at the time, other than I was still in primary school, but there was a bridge that I would always cross on my way to school. During my many days of wandering, I climbed over the barrier, fantasising of what would happen if I jumped. At least to my memory, that was my first contemplation of suicide.

I believe it was around that time that I discovered my passion for videogames, as it offered me a new form of escapism. It initially started when my parents bought me a Spectrum 128k, so that I could “do my homework”, but let’s be honest, that never happened. I discovered games such as Dizzy, various text-adventures, Double Dragon and Robocop. Particularly, Dizzy was a game that I would lose countless hours to – I absolutely adored this series as a child.

However, not long after starting middle school, the bullying continued. The combination of having the confusion of unknowingly being autistic and bearing secrets led me and my family to move to another area of town to start a new life. The bullying did stop in the most part, but my anger at the world continued to grow.

I started drinking at the age of 12. From the age of 13, I started to take mild drugs. By the age of 15, I had become alcohol dependant and had also moved on to much stronger drugs. It got to the stage in my life that I thought I’d never live out my teens.

Much of my whole life would be lived in fear, but from the age of 15 to 20, it wasn’t the drugs or drink that kept me together – it was my love for videogames. Games such as Ocarina of Time on the Nintendo 64, Resident Evil, Metal Gear Solid and Silent Hill for the original PlayStation. As videogames had done for me as an 80s child, gaming in the 90s played a huge role in giving me some happiness in a time of my life. As I approached 20, I would meet a girl who would be my soulmate and nearly 20 years later, I’m happily married with one awesome child.

My life had changed for the better, but it was still far from an easy road.

When I met my now wife, I had come out of an emotionally abusive relationship, someone that made me feel worthless and resulted in me forming an eating disorder. I’m not the tallest at 5ft 10”, but at 10 stone and ribs showing, I was still convinced that I was fat. Throughout the years that followed, my drink and drug addiction continued to grow, to the point that my whole life was dependant on it. I knew more of what it was like to be high than sober. Yet despite having the love of my life, this is where I knew my life was on a downward spiral.

Thanks to my wife, I was urged to speak to a counsellor. I believe I was in my early 20s at the time.  However, this was not a positive experience. I was trying my hardest to pluck up the courage to speak of what happened to me as a child, but my hints were falling on deaf ears. What he told me was the worst kind of advice you can give to anyone with depression. He said: “there’s always someone worse off than you”.

This advice would set me back a good 10 or so years, before I felt worthy of asking for help again. In the years that followed, I always told me wife that when we have kids, I would stop smoking, drinking and taking drugs. It’s one of the hardest things I’ve ever done. But after nearly three years of trying for a baby, the day my wife told me that she was pregnant, I stopped everything. It was really tough, but looking back now, it’s one of the proudest moments of my life. However, as crazy as it sounds, the birth of our child was when I hit the lowest point of my life.

If you suffered as a child, even when much of those memories are suppressed they can start coming back quickly when you become a parent.  You start to question if they’re real, did you dream this or was it just a childhood nightmare? I feared that I could never protect my son from the outside world.

Around this time, I had also developed severe arthritis on my hips that would practically leave me with barely any ligament or cushioning on both of the hip joints resulting in a horrible chronic pain.  I had two failed operations that rendered me physically disabled; relying on daily morphine just to take the edge off.

However, once again, video games played a huge role in my mental recovery. I discovered gaming was also a fantastic distraction from physical pain, as well as mental pain. I could take steps to make my mental wellbeing a little easier and fight back against the demons that haunted me on a daily basis. It proved to be more challenging than I ever thought it would be, but it was quite possibly my largest step in my road to recovery.

I wasn’t truly aware to the extent of how bad my depression had sank. My wife knew and I don’t think anyone else could have put up with my mental torment. I couldn’t put an exact number on it, but I had taken several overdoses via my strong medication following the birth of my son. I got really scared that the next time I would overdose, I would never wake up and my wife, and perhaps even my child, would find me on the sofa.

Speaking to a counsellor again helped realise how low my depression had sank since becoming a parent, and that depression following a birth of a was more common than I had thought. These counselling sessions were pivotal in my life. It was at this time when having Asperger’s was first suggested to me, later leading to the diagnosis. It was also the time when I summoned the courage to tell my wife what had happened to me as a child.

Being diagnosed with Asperger’s not only answered a lot of questions, but also helped me learn about my habits, social anxiety, importance of routines and how I could plan my daily life. This would be the last time that I would speak to this counsellor, but I was incredibly grateful for the impact that she had on my life. It would be a few years until I would get the ball rolling again and, in my heart, I knew that conventional counselling perhaps wasn’t what I needed.

I explained my concerns in quite some detail to a doctor. It was during this appointment that it was suggested I was suffering with PTSD. I didn’t want to believe it at the time, because I was always led to believe that only people in the military suffered with PTSD. I was only a normal, everyday person – how could I have PTSD? But the more I thought about it, the more I realised the trauma I had suffered at a very young age, as well as the years that followed, was the cause. So some months later, I took my doctor’s advice and would start my sessions of psychotherapy. This was a truly game-changing moment in my life.

It was also a scary time in my life. My memories were all in pieces and some of it didn’t make sense, but in the months that followed, these session were not only unlocking parts of my memory, but I was effectively putting together jigsaw pieces of my life.  At the time, I couldn’t see how reliving the trauma would benefit me, but these sessions helped me more then I could ever realise.

Life can be horrible and cruel, and at times nothing makes sense.  It feels like no matter how many loving people are around you, you still feel alone carrying a burden that no person should bear.

Your darkest times sneak up on your during loneliness. Sometimes time can be a healer, but it can also be your worst enemy, especially when you’re sat at home with negative thoughts. But it doesn’t matter what the generation it was in my life, video games have helped distract me from issues of self-worth, from those whispers that push you towards negativity.

No person’s story is exactly the same, but I guarantee to you, there is someone that can relate to you. For the best part of 30 years in my life I had held on to heavy burdens, but the moment I found the courage to seek help, was the moment that I began my road to recovery.

So if here’s one lesson I want you take away from reading this, please speak to someone. Whether it’s a loved one, family member, friend or a person that you’ve formed a bond with while gaming online – we live in an age now where we can communicate with more people than ever before.

To use a video game analogy; when we get tested in our lives and we continue to fight, every time we survive, every time we defeat it, we win. We keep on fighting until the next challenge comes along, and with each victory it makes us stronger. We level-up.

When you feel there is no point in carrying on, that no one could possibly understand, speak to someone. I promise you, someone does care and it might just surprise you who’ll be there for you when you need them the most.

Skills utilised:
Stories

Spotlight: Nintendo and Mental Health

Nintendo has brought joy to many since the year 1889. They started off producing handmade playing cards and have now evolved into the video games behemoth they are today. And whilst increasingly more games companies aim to nurture mental health awareness, equality and accessibility through their content, it seems Nintendo has been helping the population with mental health for quite a number of years.

When it first launched on the Nintendo DS in 2006, Dr Kawashima’s Brain Training flew off the shelves. It’s essentially a workout for the mind – a game that aims to help improve your brain age, which in turn helps with daily activities and memory skills. With health experts often suggesting we engage with tasks that help take our focus away from anxious thoughts, brain training games potentially provide that much needed mental release. In fact, a recent study found evidence that regular engagement with challenging online memory games can improve mental wellbeing in teens. Attention and emotion are apparently closely linked in the brain, so by improving attentional control through these games they were able to positively influence emotional functioning. 

Wii Fit also proved massively popular when it first launched. Both avid gamers and families were flocking to the shops every time new stock became available. Wii Fit was designed to get people gaming and exercising at the same time, whether it was to lose weight or just have fun together. The potential benefit to mental health is obvious, when we know that exercise releases endorphins and therefore reduces the intensity of mental health issues for many. The games and activities on Wii Fit could also be a way to stimulate routine, particularly for those who are house-bound due to mental health reasons. 

Then there’s Tetris. In a study by Molecular Psychiatry, they conducted an experiment in the UK with 71 patients who had just, within hours, witnessed or been involved in an incident involving psychological trauma. The patients were told to do a task such as watching TV, texting, reading or playing Tetris. 37 of the patients played Tetris for 20 minutes and the study showed that in doing so, the game offered a low-intensity therapy that could substantially reduce “intrusive memories” after trauma. Like brain training games, the focused engagement with Tetris was able to relieve stress and reduce anxiety and panic attacks. The study also showed that video games use the part of the brain that focuses on the ‘now’, rather than the past or future, preventing the patients from dwelling on the negative memories. 

Today, as we face the social challenges of the COVID-19 pandemic, the release of Animal Crossing: New Horizons on Nintendo Switch has proved to be an isolation antidote for many. Being able to connect with friends and family who are also playing the game from their living rooms eases the social distancing frustration. It’s also a haven of escapism, where you can share fruit with your neighbours or laze on a friend’s island. The possibilities are endless for creating, exploring and that all important relaxation. 

It’s clear that Nintendo has done a lot for mental health, perhaps without always realising the positive and scientific outcomes their games were going to produce. They have become known for creativity and imaginative adventures, providing true escapism from the harsh realities that many are challenged with. We can’t wait to see what Nintendo has in store for the future. 

Skills utilised:
News

Pry

Pry is a book to watch and film to touch: a story revealed by opening a character’s eyes, pulling apart his memories and grasping his infinitely scrolling thoughts.

Six years ago, James–a demolition consultant–returned from the Gulf War. Six months ago, his vision began to fail. At any point, pinch James’ eyes open to witness his external world, or collapse his thoughts to dive deeper into his subconscious.

In addition to thinking about how a character becomes more “detached” from the world, our character is also looking for answers within himself to understand past events and reconstruct memories.

Samantha Gorman, Tender Claws

Through a series of unique reading interactions, pry into a world of unreliable narration and shifted memory. A world that pushes digital publishing beyond simple mimicry of print conventions on screen.

Pry integrates reading and cinematic experience by reimagining how we can touch, open, close and pry into a text, moving seamlessly among words and images to explore layers of character’s consciousness.

Skills utilised:
Games & apps

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